Prevalence and incidence according to age, race, and ethnicity Age According to the National Diabetes Statistics Report 2020, (CDC, 2020c; 2020d;2020e): ● About 34.2 million people of all ages had diabetes mellitus. ● The percentage of adults (18 years of age or older) with diabetes increased with age. ● About 34.1 million adults 18 years of age or older) had diabetes. ● The highest percentage was 26.8% among persons 65 years of age or older. ● An estimated 4.9 million adults between the ages of 18 and 44 had diabetes. ● An estimated 14.8 million people between the ages of 45 and 64 had diabetes. ● An estimated 14.3 million people over the age of 65 had diabetes. Incidence and trends among children and adolescents. According to the National Diabetes Statistics Report 2020 (CDC, 2020c; 2020d; 2020e): ● 18,291 children and adolescents younger than age 20 years with type 1 diabetes. ● 5,758 children and adolescents age 10 to 19 years with type 2 diabetes. ● During 2011–2015, non-Hispanic Asian and Pacific Islander children and youth had the largest significant increases in incidence of type 1 diabetes. ● During 2011–2015, non-Hispanic Asian and Pacific Islander children and youth had the largest significant increases in incidence of type 1 diabetes. ● Among US children and adolescents aged 10 to 19 years (CDC, 2020c; 2020d; 2020e): ● For the entire period 2002–2015, overall incidence of type 2 diabetes significantly increased. ● During the 2002–2010 and 2011–2015 periods, changes in incidence of type 2 diabetes were consistent across race/ ethnic groups. Specifically, incidence of type 2 diabetes remained stable among non-Hispanic whites and significantly increased for all others, especially non-Hispanic blacks. Evidence-based practice! Research data shows that the number of younger people with diabetes is significant and continues to increase (CDC, 2020c; 2020d; 2020e). It is therefore essential that nurses identify those at risk and provide patient/family education regarding risk factors for the disease and how to modify these risk factors as appropriate. Racial and ethnic differences (Prevalence of diagnosed diabetes) Among the US population overall, crude estimates for 2018 were (CDC, 2020c; 2020d; 2020e): ● 26.9 million people of all ages—or 8.2% of the US population—had diagnosed diabetes. ● 210,000 children and adolescents younger than age 20 years—or 25 per 10,000 US youths— had diagnosed diabetes. This includes 187,000 with type 1 diabetes. ● 1.4 million adults aged 20 years or older—or 5.2% of all US adults with diagnosed diabetes—reported both having type 1 diabetes and using insulin. ● 2.9 million adults aged 20 years or older—or 10.9% of all US adults with diagnosed diabetes—started using insulin within a year of their diagnosis. Among US adults aged 18 years or older, age-adjusted data for 2017–2018 indicated the following (CDC, 2020c; 2020d; 2020f): ● Prevalence of diagnosed diabetes was highest among American Indians/Alaska Natives (14.7%), people of Hispanic origin (12.5%), and non-Hispanic blacks (11.7%), followed by non-Hispanic Asians (9.2%) and non- Hispanic whites (7.5%).
● American Indians/Alaska Natives had the highest prevalence of diagnosed diabetes for women (14.8%). ● American Indian/Alaska Native men had a significantly higher prevalence of diagnosed diabetes (14.5%) than non-Hispanic black (11.4%), non-Hispanic Asian (10.0%), and non- Hispanic white (8.6%) men. ● Among adults of Hispanic origin, Mexicans (14.4%) and Puerto Ricans (12.4%) had the highest prevalence, followed by Central/South Americans (8.3%) and Cubans (6.5%). ● Among non-Hispanic Asians, Asian Indians (12.6%) and Filipinos (10.4%) had the highest prevalence, followed by Chinese (5.6%). Other Asian groups had a prevalence of 9.9%. ● Among adults, prevalence varied significantly by education level, which is an indicator of socioeconomic status. Specifically, 13.3% of adults with less than a high school education had diagnosed diabetes versus 9.7% of those with a high school education and 7.5% of those with more than a high school education. Prevalence of prediabetes in adults Data regarding prediabetes in adults show that (CDC, 2020c; 2020d; 2020e): ● An estimated 88 million adults aged 18 years or older had prediabetes in 2018. ● Among US adults aged 18 years or older, crude estimates for 2013–2016 were: 34.5% of all US adults had prediabetes, based on their fasting glucose or A1C level (Table 3). ● 10.5% of adults had prediabetes based on both elevated fasting plasma glucose and A1C levels. ● 15.3% of adults with prediabetes reported being told by a health professional that they had this condition. ● Among US adults aged 18 years or older, age-adjusted data for 2013–2016 indicated: ● A higher percentage of men (37.4%) than women (29.2%) had prediabetes. ● Prevalence of prediabetes was similar among all racial/ethnic groups and education levels. Incidence of newly diagnosed diabetes in adults Among US adults aged 18 years or older, crude estimates for 2018 were (CDC, 2020c; 2020d; 2020e): ● 1.5 million new cases of diabetes—or 6.9 per 1,000 persons—were diagnosed. ● Compared to adults aged 18 to 44 years, incidence rates of diagnosed diabetes were higher among adults aged 45 to 64 years and those aged 65 years and older. ● Among US adults aged 18 years or older, age-adjusted data for 2017–2018 indicated that non-Hispanic blacks (8.2 per 1,000 persons) and people of Hispanic origin (9.7 per 1,000 persons) had a higher incidence compared to non-Hispanic whites (5.0 per 1,000 persons). Evidence-based practice! The rate of new cases of diabetes in youths younger than 20 years of age increased in the US between 2002 and 2015, with a 4.8% increase per year for type 2 diabetes and a 1.9% increase per year for type 1 diabetes (CDC, 2020g). These findings indicate that education regarding prevention and recognition of diabetes in youth must be provided with increased effectiveness, as well as aggressive efforts to prevent development whenever possible. Self-Assessment Quiz Question #1 Among U. S. adults 18 years of age and older indicated that prevalence of diagnosed diabetes was highest among: a. American Indians/Alaska Natives. b. People of Hispanic origin.
c. Non-Hispanic blacks. d. Non-Hispanic Asians. FINANCIAL AND SOCIETAL IMPACT OF DIABETES MELLITUS
The momentous financial and societal impact of diabetes continues to increase at an alarming rate. Federal, state, and local governments (and ultimately the US taxpayer) bear the brunt of costs related to diabetes. The American Diabetes Association
(ADA) gives as an example that Medicare’s diabetes-related burden increased as the prevalence of diabetes increased (O’Connell & Manson, 2019).
Book Code: ANCCUS2423
EliteLearning.com/Nursing
Page 56
Powered by FlippingBook